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Grievance and Appeals Nurse Salary
in New York-Manhattan, New York

$100,736 (USD)

Average Salary

$48/hr

Average Hourly

$1,763

Average Bonus

Salary Recap

The average pay for a Grievance and Appeals Nurse is $100,736 a year and $48 an hour in New York-Manhattan, New York, United States. The average salary range for a Grievance and Appeals Nurse is between $70,302 and $125,232. This compensation analysis is based on salary survey data collected directly from employers and anonymous employees in New York-Manhattan, New York.

Average Salary Chart

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Job Summary

Description:
  • Evaluates and resolves clinical appeals, grievances, and external reviews received from members or providers, including review of pre-service and post-service appeals, utilizing understanding of clinical department operations and claims processing procedures.
  • Communicates and interacts with external partners, including providers, medical groups, Independent Practice Associations, and other external vendors.
  • Reviews medical records related to grievances and appeals, provides monitoring of cases involving medical decisions and quality or care or service, and prepares and performs clinical reviews.
  • Logs grievances and appeals; obtains medical records as needed; and provides clinical reviews, write-ups, and recommendations.
  • Develops correspondence communicating acknowledgement and resolution to enrollees and providers, following appeal time frames.
  • Requires RN license.
Grievance and Appeals Nurse Job Prevalence in New York-Manhattan, New York, United States

Job family: Registered Nurses

Job family population: 2,906,840

Estimated population of Grievance and Appeals Nurse jobs: N/A

Rate of error: 0.5%

Salary Potential

Estimated salary in 2024:
$116,781
5 Year Change:
16 %

Education

Education data not available for this job

Skills

Skills data not available for this job

About New York-Manhattan, New York

New York-Manhattan Cost of Living Score:

Grievance and Appeals Nurse Job Listings for New York-Manhattan, New York

RN Nurse Appeals (NJ Medicaid) - Iselin, NJ - PS21170
May 15
Woodbridge Township, NJ, USA
Anthem
The Nurse Appeals is responsible for investigating and processing medical necessity appeals ... and grievances are resolved timely to meet regulatory timeframes. -Documents and logs appeal ...
A&G RN Coordinator - $10,000 Student Loan Assistance or Sign On Bonus - Brooklyn, NY
Apr 11
Brooklyn, United States
MJHS
The RN Coordinator will investigate and respond to written and/or verbal clinical appeals, expedited clinical grievances and potential quality of care grievances submitted by members and providers in ...
Nurse Practitioner SNF - ISNP Program
Apr 11
New York, NY, USA
Suit2Recruit Staffing
Follow both nursing home and reporting procedures for incidents, appeals, grievances Company Description Suit2Recruit Staffing is primarily focused on Healthcare talent acquisition placements. Our ...
Director of Nursing
Feb 26
New Brunswick, NJ, USA
College Recovery LLC
A valid license as a Nurse Practitioner (NP) in the state of New Jersey is preferred. * A minimum ... in employee grievance and appeal proceedings as indicated Community Relations: • Represent ...
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